A Comparison of the Effectiveness of Group Cognitive Behavioral Therapy and Pharmacological Treatment on Improving Mental Health and Pain Self-Efficacy in Addicts Covered by the Harm Reduction Center in Andimeshk City

This study aimed to compare the effectiveness of group cognitive behavioral therapy (CBT) and pharmacological treatment (methadone maintenance) in improving mental health and pain self-efficacy among male substance users receiving services at a harm reduction center in Andimeshk City. The study employed a quasi-experimental design with pre-test, post-test, and follow-up assessments across three groups: CBT (n = 27), pharmacological treatment (n = 27), and a control group (n = 26). Participants were selected purposively from among opioid-dependent men aged 18–57 who were registered with the harm reduction center and met inclusion criteria based on DSM-V diagnosis and psychiatrist confirmation. The intervention group received four sessions of structured CBT, while the pharmacological group underwent standard methadone maintenance therapy over the same period. Data were collected using the General Health Questionnaire (GHQ-28) and the Pain Self-Efficacy Questionnaire (PSEQ), with analysis conducted using ANCOVA and Bonferroni post-hoc tests via SPSS-20. The results showed significant differences between groups in both mental health and pain self-efficacy post-test scores. The CBT group demonstrated greater reductions in GHQ-28 scores (F(2,77) = 34.79, p < .001, η² = .479) and higher increases in PSEQ scores (F(2,77) = 41.03, p < .001, η² = .516) compared to both the pharmacological and control groups. Bonferroni post-hoc comparisons indicated that CBT was significantly more effective than pharmacological treatment and control in both outcomes (p < .001). Group cognitive behavioral therapy is more effective than pharmacological treatment in improving both psychological health and pain self-efficacy in male substance users. These findings support the integration of CBT into harm reduction programs as a complementary or alternative treatment approach to medication.